Orbital abscess after facial trauma

Abstract

This paper reports a rare case of acute severe orbital abscess manifested 2 days after a facial trauma without bone fracture in a 20-year-old Afro-American female. The symptoms worsened within the 24 h prior to hospital admission resulting in visual disturbances such as diplopia and photophobia. The clinical findings at the first consultation included fever, periorbital swelling and redness, ptosis, proptosis and limitation of ocular movements upwards, downwards, to the right and to the left. Computed tomography scan showed proptosis with considerable soft tissue swelling on the left side and no fracture was evidenced in the facial skeleton, including the zygomatic-orbital complex. After hospital admission and antibiotic therapy intravenously the patient was conducted to the operation room and submitted to incision and drainage under general anesthesia. The orbit was approached thorough both eyelids and the maxillary sinus was reached only through the Caldwell-Luc approach. The postoperative period was uneventful and the rapid improvement of symptoms was remarkable. Visual acuity and ocular motility returned to the normal ranges within 2 days after the surgical intervention. After 12 postoperative days, the patient presented with significative improvement in the ptosis and proptosis, and acceptable scars.

A Case of Late Term Posttraumatic Orbital Abscess Medical and Surgical Management

“…Orbital infections are usually caused by Staphylococcus aureus, Staphylococcus pneumonie, and Haemophilus influenzae. [2,7] The culture of this patient was positive for Staphylococcus epidermidis, which is present in the sinus and skin flora. In cases of orbital infection, the appropriate intravenous treatment should be initiated as soon as the agent is detected, and if accompanied by an orbital abscess, surgical drainage should be performed immediately.…”

“…Rare cases have been reported after nasal or orbital fractures. [2] In 1970, Chandler classified orbital infections into 5 subgroups: stage 1: preseptal cellulitis, stage 2: orbital cellulitis, stage 3: subperiosteal abscess, stage 4: orbital abscess, and stage 5: cavernous sinus thrombosis. While stages 1 and 2 are treated with medical treatment, surgical drainage is required in stages 3, 4, and 5.…”

“…While stages 1 and 2 are treated with medical treatment, surgical drainage is required in stages 3, 4, and 5. [2,4] Intraorbital foreign bodies are frequently encountered in cases of an orbital penetrating injury after a fall. Our case had a penetrating orbital and frontal sinus injury due to a tree branch as a result of a fall, and orbital cellulitis and abscess developed 3 weeks later.…”

“…Fractures are common in cases of orbital trauma, and may occasionally lead to orbital cellulitis. [1,2] In the event of a penetrating injury with a wooden or plant-based foreign body, bacteria and parasites can easily adhere and penetrate the wound site and cause infection since these materials are organic and porous. A foreign body penetrating the orbit can cause acute orbital inflammation if not removed promptly.…”

Orbital Abscess—Two Case Reports with Review

“…Occasionally, the infection etiology remains unknown despite culture sampling and isolation attempt [10,19,29,43]-according to Teena et al 68.8% of orbit specimens finds the infectious pathogen [40]. Some articles omit stating exact etiology [12,13,26].…”